University of Mississippi Medical Center is an academic medical center. We’re here supporting our research sector, our hospital sector – healthcare, and the medical school. We’re the state’s only Level I Trauma Center and the state’s only children’s hospital. Given that, we are also a state entity, so we are here to provide outstanding care for the state of Mississippi.

I’ve been on the ground here for about almost two months now. I previously came from Cleveland Clinic. I was overseas in Abu Dhabi working on the joint venture project that they had with the government of Abu Dhabi. I was there for almost two years before leaving to come back to the states. I’m originally from southern California in Los Angeles, so I’m accustomed to being in a big city throughout my life until now where I’m in Jackson, Mississippi. Overall it’s going well.

What are your biggest projects and your biggest challenges?

The biggest one now is that we’re looking at optimization. We went live with Epic about 16-17 months ago with a big bang installation. All the hospitals and all the clinics, so campus-wide we rolled out Epic, which is a very great task that was undertaken. Now we’re looking at ways to optimize it.and utilize the system to our advantage. I’ll say that’s probably the number one thing for me right now.

What are your goals for the system and what do you hope to accomplish using Epic?

I would say just utilizing the system to its fullest capability. Right now, we’re utilizing probably about 40-45 percent of the system’s functionality. I want to get it to at least 85-90 percent. In addition to that, some of the main technology initiatives are moving toward the BYOB environment and we’re moving toward virtual desktops. We’re going mobile. I want to get us where we’re one of the very few healthcare players that’s able to support a mobile environment. I want to get away from the traditional client-server setup.

What do you need in terms of infrastructure to support a mobile workforce?

We currently have Citrix as a main partner in terms of supporting Epic. We’re almost there, we’re pretty far ahead. In terms of infrastructure, we just need to take a look at some of the hardware upgrades, then we should be ready. We rolled out Citrix for all of our clients. Everything’s running through our Citrix client. What that means is that we just have to get some of the other healthcare applications to work well with our Cisco container and we should be good to go. We’re very close, closer to what I originally imagined coming on board.

Are other clinicians other than physicians going mobile as well?

Primarily physicians, medical staff and nurses. We have a really big telehealth program here. We have over 85 hospitals on site that are utilizing our telehealth program. Our goal is to get it to over 100+ sites and capture not just the state of Mississippi, but we want to capture the southeastern region of the US and potentially go global. They’re going to be a big player in terms of utilizing the mobile platform.

What’s the vision for global telehealth?

We grew so fast here, in terms of this telehealth program. I think the vision is to be able to provide care for the state of Mississippi and the rural areas first. We want to scale it to where obviously just to be able to service the area of Mississippi, but I think we have the potential to expand it globally. We need to be able to showcase and show everyone what we’re doing here in Mississippi from a telehealth perspective.

It is fast-evolving technology that right now is still very premature, so we’re scrambling at this point. But hopefully we’ll get to stage to where we’re solid and we have a few solid partners that are working with us. Then I think we’ll be able to extend it globally, working with some of the other countries that are in need of telemedicine. You know, given the fact that I was in Abu Dhabi, I see a strong need for healthcare players in North America to boost healthcare globally throughout the world.

Are there specific services that you plan to use in your own institution?

I would say anything. I don’t think the organization has thought about expanding globally, but that’s the sort of the goal that I have in place of the organization, along with my director of telehealth.

Are you doing anything else that you would consider innovative or unusual?

Telehealth and getting solid on a more mobile strategy. Those are the two primary things I would say that’s very innovative right now. We’re still trying to get some of the basics in terms of the basic functionalities in place, but from a healthcare perspective, I would say those are the two biggest areas. From a medical college standpoint, there are a lot of things we want to do as far as mobile strategy as well, but that’s something that’s still a work in progress.

You were a hospital analyst 10 years ago and now you’re the CIO of a large health system. What advice would you give people who are interested in a similar career path?

It’s very important to understand the business side of healthcare. I was fortunate enough to where I was able to roam and understand the various departments. I’ve had various departments report up to me as well, such as supply chain. I have a lot of knowledge from a revenue cycle standpoint.

I would say really get involved and understand operations, how things work. That’s going to carry a lot of weight in terms of fitting technology into the business side. After all, business drives technology, so it’s very important and very valuable for someone to actually understand how to operationalize the hospital and how to make it profitable.

In terms of educational background as well as experience, what do you think would be ideal for today’s CIO role?

A technology background would be ideal, just to understand how things work and have that foundation. But ideally, someone with a business background, specifically in the healthcare sector. If there’s a passion for that individual on the technology side, that’s a plus, primarily having to be a little more business savvy. Most of the CIOs today have been in technology for a long time and they understand technology, but when you ask them to transfer that knowledge from a technology terms to business terms, there has been a challenge.

How is your relationship with your CFO and how can CIOs improve that relationship?

What’s helped me is the fact that I work closely with my CFO as a partner. He trusts me to help him solve things that are going wrong on the revenue side because I have that knowledge from a business side as far as how to run a business office. That’s helped me tremendously in that relationship to where I’m viewed as a solid partner, not just a technology advisor. I’m there helping from a financial perspective as well. That’s what’s very critical, and that’s what’s lacking these days.

Is the industry is doing a good job of preparing the next generation of IT leadership?

No, I don’t think so. I was very fortunate that at my previous organization, AHMC Healthcare, I was very close to the chairman of the board. I had his trust and he allowed me roam and take note of the various stakeholders from a business perspective. That was how I was able to understand how healthcare operates from an operational perspective. Without that experience, I don’t think I would be where I am now. I would say that in general we do not do a good job of educating technology leaders on the business side to groom them for the next level.

Your background illustrates that sometimes you have to take jobs that are either geographically unusual or maybe not even desirable jobs to be able to move up. It’s not likely that you’ll just stay in one place and 20 years later you’ll suddenly be promoted. Do people understand that you can’t just stay put and work your way up to the one and only CIO job?

You have a point. You do have to navigate and move around a lot, just to be able to get where you want to be from a career path. Obviously you’d like to stay in one place, but there’s only one role. The chance of someone younger getting that high-profile role is a little bit tougher unless you move around and get some exposure outside the one organization.

I think you brought up a really good point as far as being able to grab on to an opportunity and take the challenge. Once folks get comfortable, it’s hard to get them out of that comfort zone. That’s a big separation divider between someone being able to lead and take on the next role.

Do you think a lot about government decisions about healthcare IT?

I do. I try to stay involved, but that piece is a little bit tougher. But given that we’re a state entity now, I am a little bit more involved than I have been in the past. I did come up from a for-profit institution as well. Now that we’re a state entity, I am heavily involved with the regulatory that goes around in healthcare IT.

Are there lessons you learned on the for-profit side that you can bring to your current employer?

Oh, yes. That was a big separation divider, given that I have a good background in terms of maximizing return on investment and being able to be profitable for an organization. That’s helped coming to this sector, where traditionally from a non-profit, academic standpoint, that has not been the key driver. As healthcare is consolidating, everyone is looking at ways to maximize their return on investment.

You weren’t there when the Epic decision was made, but what return on investment assumptions were built in? What are you measuring and expecting?

Going Epic is the right path. Every healthcare system in the US is trying to get to that consolidated platform. I think they made the right choice. The main drive, the key metric to measure, is how do we look from a revenue standpoint after go-live versus before go-live? I think we’re at the point where we’re above where we were before in terms from a revenue standpoint, but we’re still pretty far from where we can be. We’re looking at a lot of ways to optimize and be that far ahead in terms of from a revenue standpoint.

Do you think Epic will provide a positive return on investment?

We will. We’re utilizing Epic for almost every module. I think we will see a positive return.

People are always asking me what kind of healthcare IT company they should start. What would you say to somebody who’s contemplating that and wonders where the opportunities might be?

The best opportunity is to be a partner and a problem solver. Obviously if they’re not able to solve complex problems, then that niche is not there. Understand the various problems that facilities and healthcare facilities are facing these days and try to find a niche as far as where they can fit in. It’s very easy for someone to be a generalist, but I think focus on a specific area, a few specific niches. That’s where they would stand out.

A perfect example that came to my mind is I worked with a consultant that knew how to help a healthcare facility qualify for and maximize their DSH, Disproportionate Share Hospital, reimbursement. That’s a niche market. There aren’t too many people that can go into successfully and help a non-DSH hospital become qualified for DSH. These are special sort of niches that are valuable. Otherwise, it’s very hard for a small firm that is more of a generalist to be successful in the long run.

Currently there are "5 comments" on this Article:

Going Epic is right choice? “How to oprerationalize the hospital and how to make it profitable”. Have fun with that, wait til David starts paying the Epic bills! It’s funny how hospitals nowadays go all in with new IT systems thinking they will save money when in reality I would say it costs more in the long run. I’m not sure what they had at this medical center previously but they will probably be looking at training costs, consultant costs, support costs maintenance costs and a whole list of other costs for the next 15-20 years. Behind payroll, my guess is IT costs would be a close second. Any thoughts on this?

I found it interesting in your interview with Mr. Chou that the ROI on Epic seemed fairly elusive. I remain baffled as to how an organization can demonstrate an improvement in revenue cycle and operations sufficient to pay for a mega-million dollar system plus make a gain on operational improvements. Not knowing much about Mr. Chou’s employer, I am assuming (guessing) that they spent in excess of $100 million on the Epic solution. That is a lot of ROI that needs to be generated.

Out come the vendor trolls ready to jump on the latest mention of Epic. It begs the question, what was the ROI on all the systems that got replaced? Same hackneyed garbage that permeates the comments these days.

I am the CHIO at UMMC. We have the ROI from the project. Millions in annual savings from retiring our most expensive legacy systems 6 months after go-live. Millions in annual saving from a HIM restructure and reduced transcription cost. Both presented and/or published. Come to our HIMSS talk to find out more, but stop blaming vendors when hospitals don’t execute.

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